Individual
ANJAN BHATTACHARYYA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1438 S GRAND BLVD, SAINT LOUIS, MO 63104-1027
(314) 977-4850
(314) 977-4876
Mailing address
1438 S GRAND BLVD, SAINT LOUIS, MO 63104-1027
(314) 977-4828
(314) 977-4877
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
34489
IA
2084P0800X
Psychiatry Physician
Primary
34489
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07172008
—
MO
01
—
48914
WELLMARK BCBS
IA
Enumeration date
02/15/2006
Last updated
05/16/2019
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